Objective To approach the design and clinical application of large anterolateral thigh flap and its effect in wound repair.Methods The flaps were designed according to the anatomical features of perforating branches in the anterolateral thigh flaps.When a flap was chipped,a thick branch or a terminal branch of original vessel was reserved,another suitable perforating branch was selected in the proximal or distal end of the flap,and then the two vessels were anastomosed to enlarge the range of blood supply.If the vessel pedicle of a flap was a musculocutaneous perforating branch,the perforating branch of anastomosis was cut at out-point of muscle.If the vessel pedicle of a flap was a intermusclar branch or a direct skin artery,the perforating branch of anastomosis was cut widely.From May 2006 to May 2012,the technique was applied in 28 patients with large skin defect of limbs.The diameters of perforating branches obtained at out-point of muscles were measured during surgery.The survival of flaps was observed after surgery and complications in donor sites were checked during follow-ups.Results There were 18 flaps whose vessel pedicle were musculocutaneous perforating branches.The branches were cut at outpoint of muscles.The diameters of these vessels were measured during surgery.They ranged from 1.3 mm to 1.8 mm with an average of 1.45 mm.All of the vessels could be anastomosed.All 28 flaps survived.All flaps survived.The areas of the flaps ranged from 22 cm × 15 cm to 42 cm × 14 cm.Artery crisis happened in 2 flaps whose vessel pedicle were musculocutaneous perforating branches.The second look operation found that the areas of artery anastomosis of perforating branches and vessel pedicles were compressed by hematoma and thrombus formed.The 2 flaps survived after the hematoma was cleared away and the vessels were reanastomosed.There were no infections.Both the donor and recipient site healed by first intention with no necrosis of flap margin.All 28 patients were followed up by 4-13 months with an average of 8 months.There were no apparent collapse deformities,muscle necrosis,declines of muscle strength and muscle hernia in the donor sites.The appearance of flaps was flat,the color was close to normal and the quality was fine.Conclusion It is a safe and effective method to repair wound surface by large anaterolateral thigh flap obtained by the modus operandi of perforating branch anastomosis.

Objective To explore the inhibitory effects of Zibu Piyin Recipe(ZBPYR)serum on neuron apoptosis induced by tunieamyein(Tm,5 μg/ml)and its mechamsm in vitro by using sero-pharmacological method.Method Totally 12 healthy adult male SD rats(220～250 g)(SPF)were divided randomly into control group and ZBPYR group,6 in each group,then the blank and ZBPYR serum were prepared.The mouse.neuroblastoma cell line Neum2a cells were treated with Tunicamycin(Tin,an inhibitor of N-glycoslytion)to establish the endoplasmic reticulum(ER)stress model.The cells treated by ZBPYR aerum of different concentrations were interventional groups,and the cells treated by blank serum were control group.The viability of Neuro2a cells was meusurcdd by MTT assay.Flow cytometry wus applied to observe the apoptosis of Neuro2a cells.Western blotting was utilized to detect the protein expressions of two molecules,ER molecular chaperone-ucose regulated protein 78(CRP78)and transcriptional factor CCAAT/enhancer-binding protein-homologous protein(CHOP).The results were analyzed by sNK-q test.Results Compared to Tm group(cell viability 0.1673±0.0213,apoptotic rate 62.7050±1.4056),The cell viability of interventional groups(5%0.5295±0.0373,10%0.5843±0.0428,15%0.6274±0.0324)increased significantly(P<0.05);and the apoptotic rate(5%47.8733±2.8166,10%46.3366±1.2748,15%39.8833±1.0524)reduced significantly(P<0.05).The protein expressions of GRP 78(5%2.1228±0.2251,10%1.3293±0.9443,15%;15%0.0931±0.1168)and CHOP(5%1.1776±0.2927,10%0.7290±0.1708,15%0.6577±0.1883)of interventional groups reduced significantly compared with Tm group(GRP78 2.9149±0.5355;CHOP 1.6611±0.2913)P<0.05.Condusions ZBPYR serurn could increase the cell viability of Neuro2a cells treated with Tm and inhibit cell apoptosis.Thereby it may have neuroprotective effects,and the mechanism may be associated with the inhibition of ER stress and apoptosis pathway.

Objective To explore the feasibility of repairing the large area skin and soft tissue defect in thefront upper of tibia by free flap with anastomosis of saphenous vessels.Methods From June,2009 to April,2014,16 cases (10 males and 6 females) of large area skin and soft tissue defect in the front upper of tibia were treatedwith free flap.The ages ranged from 24 to 56 years old,averaged of 34.5 years old.The supportive therapy and repeated debridement combined with VSD,and designed to use free anterolateral thigh flap with anastomosis of saphenous vessels before repairing operation.Results Fourteen patients accorded with preoperative design,in which 2 cases were adopted cross leg flap anastomosis posterior tibia vessels of the healthy side (1 case of saphenous artery diameter too small,and 1 case of saphenous artery long injury degeneration,unsuitable for vascular anastomosis).All 14 flaps survived,expect 2 cases were part-necrosis in the end of the flap,and gradually healed by dressing exchange.Conclusion Reconstruction of large area skin and soft tissue defect in the front upper of tibia with free flap can use anastomosis of saphenous vessels.

Asian Continental Ancestry Group ; Case-Control Studies ; Humans ; Nitric Oxide Synthase Type III ; genetics ; Osteoarthritis ; genetics ; pathology ; PPAR gamma ; genetics ; Polymorphism, Genetic ; genetics ; Software ; Superoxide Dismutase ; genetics

Adolescent ; Adult ; Child ; Female ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Radius Fractures ; surgery

OBJECTIVETo investigate the effect of Chinese drugs for tonifying Shen on the bioactivity, cell proliferation, invasion and differentiation of human cytotrophoblast of early pregnancy.

METHODSThe human early pregnant cytotrophoblast was cultured in vitro, and treated with saline (as blank control) and drug containing serum in different concentrations (5%, 10% and 20%) respectively. The changes of morphology, proliferation and invasive capacity of cells were examined by scanning electron microscopy, MTT method, flow cytometry, Transwell invasive assay at 24 hrs, 48 hrs and 72 hrs after treatment.

RESULTSAfter cells being cultured with drug containing serum, the cytotrophoblast became abundant in microvilli, with more and prolonged pseudopodia. The cell absorbency in 490 nm wave length increased significantly (P < 0.01), cells of sub-G1 and G2/M phase obviously decreased and that of S phase increased (P < 0.01), and the cells penetrated through PET membrane in each visual field significantly increased (P < 0.01).

CONCLUSIONChinese herbs for tonifying Shen could promote the proliferation and invasive capacity of cytotrophoblast and might influence its differentiation.

Animals ; Cell Differentiation ; drug effects ; Cell Division ; drug effects ; Cells, Cultured ; Drugs, Chinese Herbal ; pharmacology ; Female ; Fertility Agents, Female ; pharmacology ; Humans ; Pregnancy ; Pregnancy Trimester, First ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Trophoblasts ; cytology

Adolescent ; Adult ; Arteries ; injuries ; pathology ; surgery ; Child ; Child, Preschool ; Extremities ; blood supply ; pathology ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Male ; Microsurgery ; methods ; Middle Aged ; Recovery of Function

The neuroimaging results of drug-resistant epilepsy patients play an important role in the surgery decision and prognosis. The aim of this study was to evaluate the impact of these results on the efficacy of epilepay surgery, and then to explore surgical benefit for epilepsy patients with negative magnetic resonance (MR) images. Twenty-four subgroups describing the outcomes of 1475 epilepsy patients with positive-neuroimaging results and 696 patients with negative-neuroimaging results were involved in the meta-analysis. Overall, the odds of postoperational seizure-free rate were 2.03 times higher in magnetic resonance imaging-positive (MRI-positive) patients than in MRI-negative patients [odds ratio (OR)=2.03, 95% CI (1.67, 2.47), P<0.00001]. For patients with temporal lobe epilepsy (TLE), the odds were 1.76 times higher in those with MRI-positive results than in those with MRI-negative results [OR=1.76, 95% CI (1.34, 2.32), P<0.0001]. For patients with extra-temporal lobe epilepsy (extra-TLE), the odds were 2.88 times higher in MRI-positive patients than in MRI-negative patients [OR=2.88, 95% CI (1.53, 5.43), P=0.001]. It was concluded that the seizure-free rate of MRI-positive patients after surgery was higher than that of MRI-negative patients. For patients with negative results, an appropriate surgery should be concerned for TLE.
China ; epidemiology ; Epilepsy ; diagnosis ; epidemiology ; surgery ; Humans ; Magnetic Resonance Imaging ; statistics & numerical data ; Neurosurgical Procedures ; statistics & numerical data ; Prevalence ; Prognosis ; Reproducibility of Results ; Sensitivity and Specificity ; Surgery, Computer-Assisted ; statistics & numerical data ; Treatment Outcome

Antineoplastic Combined Chemotherapy Protocols ; Humans ; Lymphocytes ; Lymphoma, Large B-Cell, Diffuse ; Monocytes ; Prognosis ; Retrospective Studies

BACKGROUNDRecently, new anti-epileptic drugs (AEDs) have been more frequently selected to treat epilepsy. In the present study, we evaluated the dynamic changes of efficacy and safety of three newer AEDs for treating partial epilepsy in China.

METHODSPatients were collected sequentially and were divided into three groups which accepted oxcarbazepine (OXC), lamotrigine (LTG) or topiramate (TPM) therapy. Each group included monotherapy and add-on therapy subgroups. We followed all patients for one year and recorded the indexes of efficacy and safety in detail.

RESULTSA total of 909 patients finished the follow-up observation. No significant difference was found in proportion of patients with > or = 50% reduction, > or = 75% reduction and 100% seizure reduction in the LTG and OXC groups between the first and the second six months. In the TPM group there was a statistical difference between the first and the second six months in proportion of patients with > or = 50% reduction (P = 0.002), > or = 75% reduction (P < 0.0001) and 100% seizure reduction (P = 0.009) in the monotherapy subgroup, and about > or = 75% reduction and 100% seizure reduction in the add-on therapy subgroup (P < 0.0001). The efficacy between the add-on and monotherapy subgroups showed a statistical difference. The safety of the three newer AEDs was good.

CONCLUSIONSThe three newer AEDs all showed good efficacy and tolerability for partial epilepsy. And the efficacy can be maintained for at least one year.

Anticonvulsants ; therapeutic use ; Carbamazepine ; analogs & derivatives ; therapeutic use ; China ; Epilepsies, Partial ; drug therapy ; Follow-Up Studies ; Fructose ; analogs & derivatives ; therapeutic use ; Humans ; Treatment Outcome ; Triazines ; therapeutic use